D9944 is the CDT code for a custom-fabricated hard acrylic occlusal guard that covers the full arch. It was introduced in 2020 as the current replacement for the retired legacy code D9940, which was too broad to distinguish appliance type and coverage. D9944 specifically covers hard-material, full-arch night guards typically used to manage bruxism and protect against occlusal wear.
Last updated June 2026 · Reviewed by the PracticeAlpha billing team
Get help with D9944 claims →Patient presents with evidence of nighttime grinding, occlusal wear facets, tooth sensitivity, or reported muscle fatigue. A hard full-arch guard is fabricated to protect enamel and reduce parafunctional forces during sleep.
A hard stabilization splint is prescribed as part of conservative temporomandibular disorder management. The appliance distributes occlusal forces evenly and reduces joint loading. Document the TMD diagnosis clearly in the chart.
Patient has received extensive restorative or prosthetic treatment and a night guard is prescribed to protect the new restorations from parafunctional loading. Hard full-arch coverage is indicated when all teeth on an arch need protection.
Do NOT use D9944 for: Soft-material full-arch guards (use D9945). Hard guards covering only a partial arch (use D9946). Soft partial-arch guards (use D9947). Removable orthodontic retainers. Sports mouthguards (use D9941). Over-the-counter or patient-fabricated appliances are not billable under any D99 code.
Note on legacy D9940: The retired D9940 code was used for all occlusal guards before the 2020 CDT update. If a payer's fee schedule still references D9940, verify internally how they crosswalk it. Submitting D9940 on a current claim will often result in a denial or delay because many clearinghouses and payers no longer recognize it as an active code.
Many dental plans classify occlusal guards as non-covered services. Before fabricating the appliance, verify the patient's benefits. If the plan excludes occlusal guards, the patient should sign a financial agreement acknowledging full responsibility. Do not assume coverage based on plan type. Some PPO plans cover guards; many DMO and Medicaid plans do not.
Payers that do cover D9944 typically require documented evidence of bruxism, clenching, or TMD. A note that says "patient wants a night guard" is not sufficient. The clinical record should describe wear facets, muscle tenderness, patient-reported symptoms, or other objective findings. Reference the diagnosis code (ICD-10) in the claim when required.
Plans that cover occlusal guards often limit reimbursement to one appliance every three to five years. If the patient had a guard billed within that window, the claim will be denied for frequency even if the original appliance was lost or broken. Check the patient's claims history before submitting.
D9940 was retired in 2020. Some older practice management systems may still default to D9940. Submitting a claim with the retired code will cause a denial or rejection. Confirm your software is mapped to D9944 for hard full-arch guards, D9945 for soft full-arch, and D9946 for hard partial-arch.
Document the indication: bruxism, TMD, occlusal wear, or parafunctional clenching. Include objective findings such as wear facets, muscle tenderness, or incisal edge chipping. Vague entries like "night guard requested" do not satisfy medical necessity requirements for payers that cover the service.
The lab prescription or in-office fabrication record must confirm the appliance is made of hard acrylic and covers the full arch. This is what distinguishes D9944 from D9945, D9946, and D9947. Keep the lab slip in the patient record.
Some payers require an ICD-10 code when submitting D9944. Common applicable codes include F45.8 (bruxism) or codes in the M26.6x range for TMJ disorders. Confirm the ICD-10 requirement with the specific payer before submitting.
Some plans require prior authorization for occlusal guards. Check the patient's specific plan before scheduling delivery. Submit the pre-auth with clinical notes and a description of the appliance. Document the authorization number in the chart and include it on the claim.
When the guard is indicated for TMD management, some payers request radiographic documentation showing joint involvement. Panoramic or TMJ-specific images may be required to support the claim or pre-authorization request.
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Learn about our billing servicesD9944 is the current CDT code for a custom-fabricated hard full-arch occlusal guard. It was introduced in 2020 as part of the restructuring that retired legacy code D9940, allowing payers and providers to distinguish between hard vs. soft and full-arch vs. partial-arch appliances.
D9940 was retired in 2020 and replaced by D9944 (hard, full arch), D9945 (soft, full arch), D9946 (hard, partial arch), and D9947 (soft, partial arch). Submitting the retired D9940 code on a current claim will typically result in a denial or rejection.
D9944 is a hard acrylic full-arch guard. D9945 is a soft (flexible or thermoplastic) full-arch guard. The material type determines which code applies. Confirm the appliance material with your lab before billing.
D9944 covers the full arch. D9946 covers a partial arch. Both are hard appliances. If the guard only protects a segment of the teeth rather than the entire arch, D9946 is the correct code.
Common reasons: the plan excludes occlusal guards as non-covered, missing bruxism or TMD documentation, frequency limitations (one guard every 3-5 years), billing the retired D9940 code, or failure to obtain required pre-authorization.
In some cases, yes. When a hard occlusal guard is prescribed for documented TMD management, some medical plans will consider coverage under a relevant ICD-10 diagnosis. Medical billing requires a different claim format and supporting clinical documentation. Verify requirements with the specific medical plan before submitting.
Search all 206 CDT codes in our dental coding guide.